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Step2 CK > Infection Disease Antibiotics > Flashcards

Infection Disease Antibiotics Flashcards

1
Q

Coverage of ampicillin and amoxicillin

A

Same as penicillin (strep Viridans and pyogenes, syphillis, leptospira and oral anaerobes) AND E. coli, Lyme disease , listeria and some gram negative bacilli (hemophilus, proteus, salmonella)

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2
Q

What types/location of infections are ampicillin and amoxicillin used for most commonly?

A

Otitis media
Dental infection and endocarditis prophylaxis
Early Lyme disease (age

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3
Q

What are the four penicillinase-resistant penicillins?

A

Oxacillin, cloxacillin, dicloxacillin and nafcillin

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4
Q

What type of infection/location are the penicillinase-resistant penicillins used for?

A 
Skin infections (cellulitis, impetigo, erysipelas)
Endocarditis, meningitis or bacteremia due to staph
Sensitive osteomyelitis and septic arthritis
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5
Q

Why is methicillin no longer used?

A

Cause renal failure due to allergic interstitial nephritis

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6
Q

What type of infection/location are penicillinase-resistant penicillins not useful in treating?

A

MRSA

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7
Q

What are four extended spectrum penicillins?

A

Pipracillin, ticracillin, azocillin and mezlocillin

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8
Q

What is the coverage for extended spectrum penicillins?

A

Gram negative bacilli (E.coli and proteus) AND pseudomonas

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9
Q

What types/locations Of infections are extended spectrum penicillins used for?

A 
Cholecystitis and ascending cholangitis
Pyelonephritis 
Bacteremia
Hosp-acquired and vent associated pneumonia 
Neutropenia and fever
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10
Q 
What beta lactamase would you pair with:
Pipracillin
Amoxicillin
Ticracillin 
Ampicillin
A

Pipracillin/tazobactam
Amoxicillin/clauvalanic acid
Ticracillin/clauvalanic acid
Ampicillin/sulbactam

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11
Q

How does adding a beta lactamase change the efficacy of penicillins?

A

Added coverage of sensitive staph

They cover anaerobes and are first line for mouth/GI abscess

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12
Q

What bacteria are resistant to all generations of cephalosporins?

A

MRSA, listeria and enterococcus

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13
Q

If a patient is allergic to penicillin and his reaction is a rash what type of antibiotic do you substitute?

A

Cephalosporins; only a small chance of cross reaction (3%)

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14
Q

If a patient is allergic to penicillin and his reaction is anaphylaxis what type of antibiotic do you substitute?

A

Non-beta lactam antibiotic

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15
Q

What organisms do ALL generations of cephalosporins cover?

A

All cover: group A,B,C strep , Viridans group strep, E.coli, Klebsiella and proteus

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16
Q

What are the first generation cephalosporins ?

A

Cefazolin, cephalexin, cephradrine and cefadroxyl

17
Q

What is the coverage of first generation cephalosporins ?

A

Methicillin-sensitive staph
Strep except enterococcus
Some gram negative bacilli (E.coli)
Osteomyelitis , septic arthritis, endocarditis and cellulitis

18
Q

What are the second generation cephalosporins ?

A

Cefotetan, cefoxitin, cefaclor, cefprozil and cefuroximine

19
Q

What is the coverage for second generation cephalosporins ?

A

Same as first generation: Methicillin-sensitive staph
Strep except enterococcus
Some gram negative bacilli (E.coli)
Osteomyelitis , septic arthritis, endocarditis and cellulitis

ADD anaerobes and more gram negative bacilli

20
Q

What types of infections/locations are second generation cephalosporins used to treat?

A

Cefotetan and cefoxitin: used for PID in combo with doxycycline
Cefuroxime and cefprozil: respiratory infections (bronchitis, otitis media and sinusitis)

21
Q

What are third generation cephalosporins?

A

Cefotaxime , ceftriaxone and ceftazidime

22
Q

What side effect/ adverse reaction is characteristic of cefotetan and cefoxitin?

A

They have increased risk of bleeding because of depleted prothrombin and can cause a disulfiram-like reaction when mixed with alcohol

23
Q

What type/location of infections is ceftriaxone used to treat?

A 
First line for pneumococcus 
Meningitis
Community acquired pneumonia (with macrolide)
Gonorrhea
Lyme disease involving brain or heart
24
Q

In what pt population is ceftriaxone avoided? And what can be used instead?

A

In neonates due to decreased biliary metabolism

Cefotaxime is superior in neonates

25
Q

What type/location of infections is cefotaxime used to treat?

A

Spontaneous bacterial peritonitis

26
Q

What makes ceftazidime different to ceftriaxone and cefotaxime?

A

It has pseudomonal coverage

27
Q

What is the fourth generation cephalosporin?

A

Cefepime

28
Q

What does cefepime cover and what type/location of infections is it used for?

A

Cefepime has better staph coverage compared to 3rd gen.
It is used to treat neutropenia with fever
Ventilator associated pneumonia

29
Q

What cephalosporin has MRSA coverage?

A

Ceftaroline

30
Q

What are two main carbapenems?

A

Imipenem and meropenem

31
Q

What coverage do carbapenems have?

A

Gram negative bacilli, anaerobes, strep, staph

32
Q

What types/location of infections are cabapenems used for?

A

Neutropenia with fever

33
Q

What is the only monobactam antibiotic?

A

Aztreonam

34
Q

What is the coverage of Aztreonam and what makes it special in relation to penecillins?

A

Exclusively covers gram negative bacilli including pseudomonas
And has no cross-reactivity with penicillins

35
Q

What is the best initial treatment for gram positive cocci?

A

Gram positive cocci include staph and strep
Best initial treatment is :
-extended spectrum penicillins (Oxacillin, nafcillin)
-first generation cephalosporins
-flouroquinilones
-macrolides are 3rd line because less efficacious

36
Q

What is the best treatment for MRSA?

A 
Vancomycin 
Linezolid
Daptomycin
Tigecycline
Ceftaroline
37
Q

What is the SE/AE of linezolid?

A

Reversible bone marrow toxicity

38
Q

What is the SE/AE of daptomycin?

A

Elevated CPK

39
Q

Coverage for penicillin

A

Strep Viridans and pyogenes, syphillis, leptospira and oral anaerobes

Step2 CK (12 decks)

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